Any time someone is going through fertility treatments that involve the use of fertility drugs to increase follicle stimulation, they run a risk of developing Ovarian Hyperstimulation Syndrome (OHSS). OHSS occurs when too many follicles develop and the ovaries become enlarged.  While many people using fertility drugs report discomfort during the time of ovulation, those who experience OHSS report severe pain and discomfort among other symptoms and often end up in the hospital for treatment and monitoring.

The first thing that people want to know is what causes OHSS.  The truth is the exact cause is unknown.  Why one person develops it and someone else doesn’t is yet to be determined.  Why a person might develop it during one cycle and the same person does not develop it on a subsequent cycle is still a mystery.  All that is known is that the use of follicle stimulating fertility drugs puts you at risk of developing OHSS.

All that being said, there are some women who seem to be at higher risk than others.  Women who are under age 30, women who are underweight, women who have used hCG for support during the luteal phase, women with polycystic ovarian syndrome, women who have been administered a GnRh agonist, women who have had a previous occurrence of OHSS and women with a large number of eggs or follicles and high estrogen levels all are at a higher risk of developing OHSS.

The best way to treat or prevent OHSS is to monitor follicles through ultrasounds and hormones through blood work.  By comparing estrogen levels and follicle development, doctors can better predict if OHSS is a possibility.  If it appears that it is a possibility, doctors should not administer the hCG until they do subsequent tests.  If you are doing IVF, some doctors may opt to collect eggs, inseminate them and then freeze the embryos for a future IVF procedure using the frozen embryos.  There is also the possibility of stopping the gonadotropin stimulation while continuing to suppress the estrogen levels to make them decline and then doing the egg collection when the estrogen levels are at an appropriate level.  Doctors might also impose such restrictions as limiting or stopping any type of exercise, household activities such as vacuuming or sexual intercourse.

Since the only way a doctor can know whether or not you have OHSS is through monitoring you with blood work and ultrasounds, you need to be aware of the symptoms of the syndrome.  If you experience any of the following, you should report it immediately to your doctor: abdominal pain, diarrhea, nausea and vomiting, abdominal bloating, breathing problems, infrequent need to urine, dark urine or sudden weight gain.

The complications of OHSS can be severe and should not be taken lightly.  Although severe OHSS is rare, it can lead to permanent damage, injury or death.  There are many complications associated with OHSS.  A common complication is twisting of the swollen ovaries (ovarian torsion) that can result in the removal of your ovaries.  Other complications include fluid in the lungs and stomach, blood clots and loss of the functions of your liver and/or kidneys.

Although the exact cause of Ovarian Hyperstimuation Syndrome or OHSS is unknown, knowing the risk categories that you fall under and being aware of your body and how you feel during fertility treatments is important and careful monitoring by your doctor is essential.  Because the complications can be severe, it is always good to be one step ahead of OHSS to prevent ever developing one of them.  Even though the development of severe OHSS is uncommon, it is better to be safe and careful during your treatment to protect your health and to help with the success of the treatment.

When couples are going through fertility treatments that involve using fertility drugs to increase follicle stimulation and the production of eggs such as IUI or IVF, there is always a risk for Ovarian Hyperstimulation Syndrome (OHSS).  This is a very serious complication that can result in a hospital stay and could be fatal if it was not monitored and treated accordingly.  When too many follicles develop, the ovaries can become swollen and enlarged.  OHSS can cause severe pain and fluid to be released into the lungs and abdomen.

To understand OHSS, we must first talk about the process of ovarian stimulation itself.  When going through fertility treatments, doctors often used medications to help stimulate ovarian production.  It is most typically used for procedures such a IUIs or IVF but is also used for other situations such as causing ovulation in women who are not ovulating on their own.

The typical drugs used for ovulation induction are Clomid and Gonadotropins.  Their job is to increase the number of egg follicles for ovulation.  You can be given different dosages of these medications depending on such things as your age, the type of fertility procedure you are doing and past stimulation results from using them.

When you are going through a fertility treatment, your doctor should maintain a regular monitoring schedule for your hormones, the number of follicles and the size of your ovaries.  They should do this through both blood work and ultrasounds.  Monitoring these things regularly is important as it is the only way to diagnose OHSS.  About 3-5% of the women using these drugs may develop OHSS during the fertility treatment, so monitoring is essential.

When a woman experiences OHSS, she will most likely begin to have the symptoms about 3-5 days after egg retrieval.  The symptoms can be mild, moderate or severe.  Most women only have mild or moderate OHSS and the symptoms will only last a few days. Sometimes pregnancy may actually cause the symptoms to last longer.

Women with mild to moderate OHSS may have any of the following symptoms: pain, abdominal swelling and the feeling of being bloated.  At times ovarian cysts form and fluid shows up in the abdominal cavity.  Ovarian swelling for the mild form of OHSS is less than 5 cm and it is 5 to 10 cm for the moderate form.

Only about 1-2% of women who experience OHSS have the severe form of the condition.  The ovaries swell and become larger than 10 cm.  Nausea, vomiting and severe abdominal pain occurs.  The fluid backs up into the chest and abdominal cavity resulting in shortness of breath and swelling of the abdomen.  Severe OHSS typically requires a hospital stay to treat the symptoms and monitor the ovaries and fluid.  Kidney damage, blood clotting disorders and Ovarian Torsion (twisting of the ovaries) have all been associated with severe OHSS.

Any time that you are doing fertility treatments it is important for you to be aware of the symptoms of OHSS. Although it can only be officially diagnosed by the monitoring of a doctor, you can be aware of the changes in your body.  Extreme bloating, pain or discomfort should be reported immediately to your doctor.  Although OHSS can’t be prevented at this time, early detection can prevent the onset of severe OHSS.